Revisão teórica do diagnóstico de enfermagem comunicação verbal prejudicada

Abstract

The study aimed to review the elements that make up the nursing diagnosis Impaired verbal communication according to the conceptual analysis. For concept analysis, the model proposed by Walker and Avant was used as a reference through an integrative literature review. A literature search was carried out in the following databases: CINAHL, COCHRANE, LILACS, SCOPUS and PubMed, using the descriptors: “verbal communication”, “communication disorders” and “communication barriers”. From the application of the inclusion and exclusion criteria, 55 articles were selected in Portuguese, English and Spanish, which supported the concept analysis. The concept of communication was analyzed and subsequently that of Impaired Verbal Communication with the help of books, dictionaries and additional articles to the integrative review. The possible uses of the concept were then identified, determination of critical or essential attributes, construction of a model case and an opposite case. Therefore, it was found that the definition of the nursing diagnosis Impaired verbal communication present in the NANDA-I taxonomy is more comprehensive than the title of the diagnosis, as it includes elements of non-verbal communication, therefore a new definition of the diagnostic label was proposed Impaired verbal communication. Subsequently, a conceptual analysis of its defining characteristics took place, including the elaboration of conceptual and operational definitions. Currently, 26 defining characteristics are proposed by NANDA-I, of which only 9 were evidenced as resulting from the occurrence of impaired verbal communication. Six defining characteristics behaved as elements of nonverbal communication. It was then found that six defining characteristics behave as related factors of the aforementioned diagnosis (“Disorientation in time”, “Disorientation in space”, “Disorientation in relation to people”, “Total visual deficit”, “Partial visual deficit” and “Dyspnea”). Similarities were found between six defining characteristics that conveyed the idea of difficulties in verbalizing/speaking, which were condensed into two distinct defining characteristics. Finally, four defining characteristics not included in NANDA-I were identified: “Indistinct pronunciation”, “Inability to write”, “Inability to read” and “Inability to use devices to communicate”. Conceptual and operational definitions of the factors related to the nursing diagnosis in question were also created in accordance with the literature consulted. NANDA-I currently presents 17 factors related to impaired verbal communication, of which only four were not evidenced in the literature. Three other related factors not present in NANDA-I were identified: “Memory problems”, “Fatigue” and “Altered consciousness”. The four defining characteristics that were identified as related factors after the conceptual analysis were added, and those defined as visual deficits were incorporated into the related factor “Altered perceptions” and this was broken down into “Altered visual perception” and “Altered auditory perception” . Finally, the structure of the nursing diagnosis Impaired verbal communication is proposed according to the conceptual analysis containing 11 defining characteristics and 21 related factors. It is expected that this study will provide support for the subsequent stages of content analysis by experts and clinical validation in order to contribute to the refinement of the diagnosis of Impaired Verbal Communication in such a way that it is as close as possible to clinical practice.